Hongliang Chen1, Kejin Wu2, Maoli Wang1, Fuwen Wang1, Mingdi Zhang1, Peng Zhang1. 1. Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China. 2. Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China. Electronic address: kejinwu1128@163.com.
Abstract
BACKGROUND: Standard mastectomy has long been the recommended breast surgical treatment for non-metastatic inflammatory breast cancer (IBC). The objective of this population-based study was to evaluate the significance of various breast surgical treatments for this highly aggressive subtype. METHODS: The Surveillance, Epidemiology, and End Results program registry was searched to identify women with non-metastatic IBC receiving standard treatment including breast surgery, radiation therapy and chemotherapy diagnosed between 1998 and 2013. Comparisons of the proportions of various breast surgery procedures over the years were performed using Pearson's chi-square test. Breast cancer-specific survival (BCSS) and overall survival (OS) were estimated using the Kaplan-Meier product limit method and compared across groups using the log-rank statistic. Cox models were then fitted to compare the association between various breast surgical procedures and BCSS or OS after adjusting for patient and tumor characteristics. RESULTS: A total of 3374 cases were identified. Over the years, the proportion of contralateral prophylactic mastectomy (CPM), breast reconstruction and both were increasing. The proportion of implant-based reconstruction was also increasing with no difference in survival compared with other types of reconstruction. There was no statistically significant difference in BCSS or OS among various breast surgery treatments, such as breast conserving surgery, CPM, breast reconstruction and standard unilateral mastectomy. CONCLUSIONS: Breast surgery is of great significance to the clinical outcome of IBC. Standard mastectomy should not be the only recommended breast surgical treatment.
BACKGROUND: Standard mastectomy has long been the recommended breast surgical treatment for non-metastatic inflammatory breast cancer (IBC). The objective of this population-based study was to evaluate the significance of various breast surgical treatments for this highly aggressive subtype. METHODS: The Surveillance, Epidemiology, and End Results program registry was searched to identify women with non-metastatic IBC receiving standard treatment including breast surgery, radiation therapy and chemotherapy diagnosed between 1998 and 2013. Comparisons of the proportions of various breast surgery procedures over the years were performed using Pearson's chi-square test. Breast cancer-specific survival (BCSS) and overall survival (OS) were estimated using the Kaplan-Meier product limit method and compared across groups using the log-rank statistic. Cox models were then fitted to compare the association between various breast surgical procedures and BCSS or OS after adjusting for patient and tumor characteristics. RESULTS: A total of 3374 cases were identified. Over the years, the proportion of contralateral prophylactic mastectomy (CPM), breast reconstruction and both were increasing. The proportion of implant-based reconstruction was also increasing with no difference in survival compared with other types of reconstruction. There was no statistically significant difference in BCSS or OS among various breast surgery treatments, such as breast conserving surgery, CPM, breast reconstruction and standard unilateral mastectomy. CONCLUSIONS: Breast surgery is of great significance to the clinical outcome of IBC. Standard mastectomy should not be the only recommended breast surgical treatment.
Keywords:
Breast cancer-specific survival; Breast conserving surgery; Breast reconstruction; Contralateral prophylactic mastectomy; Inflammatory breast cancer; Mastectomy; Overall survival
Authors: Kate R Pawloski; Andrea V Barrio; Mary L Gemignani; Varadan Sevilimedu; Tiana Le; Joseph Dayan; Monica Morrow; Audree B Tadros Journal: J Am Coll Surg Date: 2021-05-03 Impact factor: 6.532
Authors: Naoto T Ueno; Jose Rodrigo Espinosa Fernandez; Massimo Cristofanilli; Beth Overmoyer; Dan Rea; Fedor Berdichevski; Mohamad El-Shinawi; Jennifer Bellon; Huong T Le-Petross; Anthony Lucci; Gildy Babiera; Sarah M DeSnyder; Mediget Teshome; Edward Chang; Bora Lim; Savitri Krishnamurthy; Michael C Stauder; Simrit Parmar; Mona M Mohamed; Angela Alexander; Vicente Valero; Wendy A Woodward Journal: J Cancer Date: 2018-04-06 Impact factor: 4.207